HEALTH LEGISLATION AMENDMENT BILL 2009
Agreement in Principle
Debate resumed from 25 March 2009.
Mrs JILLIAN SKINNER
(North Shore—Deputy Leader of the Opposition) [12.29 p.m.]: I lead for the Coalition in debate on the Health Legislation Amendment Bill and indicate at the outset that we will not oppose the legislation. This bill is another in the series of bills that crop up every year to tidy up a number of health Acts, to take into account things that have arisen in the meantime and to make them consistent with common practice. The bill amends various health Acts, including the Health Care Complaints Act. It adopts recommendations made during the review of the case of Graeme Reeves by retired Federal Court Judge Deidre O'Connor, and it provides for the Health Care Complaints Commission to compel the production of evidence that may assist in assessment or investigation of a complaint. Other administrative amendments to the Health Care Complaints Act relate to the commission's obligations and rights to give information to parties involved in a complaint, and allow the commission to prohibit an unregistered practitioner if he or she imposes a risk to the health and safety of the public. Currently this applies only to risk to health.
In relation to the amendments to the Health Care Complaints Act, the Association of Anaesthetists has asked for a matter to be clarified, and I ask the Parliamentary Secretary to address this matter in his response. The association suggests that there is potential for new section 28A (6) in schedule 1.3 to the bill to be amended, although I am not sure that it is necessary. The association is worried that this part of the Act does not cover contractors, that is, visiting medical officers, although I suspect that it is intended to cover them. Perhaps the Parliamentary Secretary could spell that out in his response. If there is any lack of clarity, then perhaps that needs to be considered. The bill also amends the Drug and Alcohol Treatment Act to allow a doctor to grant a leave of absence to a person detained in a detention centre for medical purposes, and to allow for short-term involuntary detention and treatment of a drug-dependent person.
Amendments to the Health Administration Act provide for appointment to the Medical Services Committee for a maximum of three four-year terms, instead of the current maximum of five two-year terms. The amendment to the Health Services Act removes the requirement that the Minister appoint a member of staff to the board governing bodies that come under the Act, that is, the Clinical Excellence Committee, HealthQuest and Justice Health. I note that claims have been made that there may be too few staff to avoid a conflict of interest if the requirement to appoint a member of staff is retained. The Act is amended to provide protection for a person who blows the whistle on poor performance or conduct—something that I strongly support. I am a little worried about this; I wonder which bodies have too few staff to avoid a potential conflict of interest if a member of staff should be appointed to the boards. Perhaps the Parliamentary Secretary could address that matter as well. Is it the Health Care Complaints Commission board, HealthQuest or Justice Health? I am not sure of staff sizes, which gives rise to that question.
This bill also amends the Medical Practice Act to allow a complainant and the subject of a complaint to have legal representation at an inquiry before a professional standards committee. The Australian Medical Association [AMA], which I have consulted, together with a number of other organisations that I will identify shortly, strongly supports this amendment. The Australian Medical Association believes that the changes to the Act last year mean that legal representation is appropriate to ensure that a doctor is adequately represented. In fact, proceedings were, on balance, a fair process. The Mental Health Act is amended to clarify that when an affected person is the subject of a current community treatment order that person is required to be given written notice of the application. A copy of the treatment plan will apply, but a 14-day notice period does not apply. The bill provides for the President of the Mental Health Review Tribunal to be either full -time or part -time.
As I said, my response to this legislation is short because it reflects the general views of those whom I consulted, that is, there is general support. I consulted the New South Wales branch of the Australian Medical Association, the New South Wales division of the Royal Australian College of Surgeons, the Association of Anaesthetists, the Royal Australian College of Physicians, the Mental Health Coordinating Council and the Health Services Association of New South Wales. I took on board the email that the Health Services Association sent to the Government, in which it indicated that it was unhappy that it had not been consulted in the development of the legislation. I also consulted my colleague the shadow Minister for healthy lifestyles, which encompasses mental health. As I said at the outset, we do not oppose this legislation. The amendments appear to reflect current practice or tidy-up provisions to make it fairer and more effective all round.
Mrs JUDY HOPWOOD
(Hornsby) [12.35 p.m.]: The Health Legislation Amendment Bill makes miscellaneous amendments to various Acts administered by the Minister for Health. The objects of this bill are:
(a) to amend the Drug and Alcohol Treatment Act 2007
(i) to remove the requirement that a medical practitioner who grants a person a leave of absence from a treatment centre must be satisfied that the person is medically fit, and
(ii) to include a transitional provision that allows persons who have been detained for treatment under the Inebriates Act 1912
, within an area that is subsequently prescribed for the purposes of the Drug and Alcohol Treatment Act 2007
, to continue to be detained under the Inebriates Act 1912
(b) to amend the Health Administration Act 1982
to provide that members of the Medical Services Committee may be appointed for 3 terms of office, with each term of office being 4 years, and
(c) to amend the Health Care Complaints Act 1993
as I am a member of the Committee on the Health Care Complaints Commission I will make further comments about that shortly—
(i) to provide that the Health Care Complaints Commission (the Commission
) may compel a person to give information, produce documents or answer questions that would assist the Commission in assessing a complaint or carrying out an investigation, and
(ii) to provide that following the assessment of a complaint the Commission is not required to give notice of its decision to a person in certain circumstances, and
(iii) to provide that following the investigation of a complaint the Commission may provide the outcomes of the investigation to certain persons and a report of the outcome of the investigation to the complainant, and
(iv) to provide that in circumstances in which the Director of Proceedings determines that a complaint should not be prosecuted before a disciplinary body, the Director may refer the complaint to the Commission for alternative action, and
(v) to provide that the Director of Proceedings may give notice of the Director's decision about whether or not to prosecute a complaint to certain persons, and
(vi) to provide that the Director of Proceedings may delegate his or her functions with respect to a particular complaint to an officer of the Commission, and
(vii) to provide that the Director of Proceedings may undertake functions imposed on the Commission by Acts other than the Health Care Complaints Act 1993
(viii) to provide that a person cannot be compelled to give evidence about, or produce documents containing, information obtained in exercising a function under the Act except in limited circumstances, and
(ix) to provide that the Commission, or a member of staff of the Commission, may disclose information obtained in exercising a function under the Act to certain persons.
This bill also amends the Health Services Act 1997—I will not go into that in detail. It amends the Mental Health Act 2007 to clarify that, in respect of an application for a further community treatment order under that Act, the requirement to give 14 days notice does not apply, and provides that the President of the Mental Health Review Tribunal may be appointed as a full-time or part-time member. The bill also amends the Medical Practice Act 1992. I will refer to the mental health aspect that does not directly relate to this bill. The latest national snapshot from the Australian Bureau of Statistics states:
Nearly half the population has a common mental health problem at some point during their lives, and about one in five has a mental condition in any given year.
I know that is not news to many members of this House, but it is important to continually remember that statistic. On 26 March 2009 a very good article appeared in the Daily Telegraph
by Adam Cresswell, who wrote:
Until this year, we always used to say one in five Australians would experience a mental health disorder in their lifetime, Barbara Hocking, executive director of the mental health charity SANE Australia.
"With these recent findings, we say it's one in five in a 12-month period."
The ABS figures, which draw on statistics originally published late last year or earlier, count substance abuse or dependency, including with alcohol, among the mental disorders on which the finding is based.
I also draw the attention of the House to the need for increased mental health screenings for police officers and for increased training for police officers in mental health issues. A project is underway but, unfortunately, it does not extend to enough police officers in this State. I refer to a program on 27 March 2009 on ABC radio during which it was stated:
The New South Wales deputy coroner has recommended senior police officers get regular mental health screenings after a Sergeant with post-traumatic stress disorder committed suicide in the Hunter Valley.
As a member of the Schizophrenia Fellowship Board I know police officers should have the assistance of information on mental health issues. I also am aware that the role they play in relation to people with a mental illness is discussed on a regular basis. I encourage the Government to take on board the need to give as much assistance as possible to police officers not only to assist them to manage people with a mental illness but also to manage their own mental health issues that they face in their workplace. About 15 years ago when my sister was a member of the Victorian Police Force she suffered mental anguish when she discovered a mother and a child who had suicided in a car at the beach. The police have to face and deal with many similar occurrences. I know this is also a Federal issue, but I have long thought that not enough is done for soldiers who return from active duty overseas. I refer to an article on 30 March 2000 in the Sydney Morning Herald
entitled, "Traumatised soldiers get 'inadequate' care" written by Nick McKenzie, that states:
MOST of Australia's former soldiers with trauma-related mental health problems, including Iraq and Afghanistan veterans, are receiving inadequate care, an investigation has found.
The confidential inquiry has found that Defence and Veterans' Affairs departments are failing soldiers who are discharged with mental health problems, and that a review of post traumatic stress disorder programs must be "urgently commissioned".
The lack of support given to soldiers before they are sent overseas to places at war and when they return also has implications for the New South Wales Government. The amendment to the Health Care Complaints Act 1993 was the direct result of the circumstances surrounding Dr Graeme Reeves, who was found responsible for certain actions that caused great distress to a number of women in New South Wales. The Committee on the Health Care Complaints Commission will discuss the amendments in greater detail, but at this time the amendments are welcomed to improve the manner in which the Health Care Complaints Commission undertakes its work.
Dr ANDREW McDONALD
(Macquarie Fields—Parliamentary Secretary) [12.45 p.m.], in reply: I thank the Opposition for its support of this legislation, which has been widely discussed with stakeholders. The Health Services Act has established a number of board-governed health corporations, being the Clinical Excellence Commission, HealthQuest and Justice Health. Justice Health is the only one that has more than 50 members. Section 49 of the Act currently requires the Minister to appoint to the board at least one member who is a member of staff of the relevant organisation. However, with the smaller board-governed health corporations, the requirement that a staff member must sit on the board may compromise the ability of the board to operate effectively.
This is because there may not always be a staff member with both the skills and expertise to perform as an effective board member; because the board member is unable to maintain the strict confidentiality of board business; or because the board member confuses their responsibilities as a board member and any perceived responsibilities to the staff of that organisation. Therefore, the proposed amendment to section 49 of the Act will remove the requirement to appoint a member of staff to the board of a board-governed health corporation with fewer than 50 members. However, the proposed amendments to section 49 do not prevent the Minister from appointing a member of staff to the board where he or she considers that that is the most appropriate appointment.
As to the concerns of anaesthetists about new section 28A (6) in schedule 1.3 to the bill, they were not raised with the Minister prior to the drafting of the bill and I recommend a question to the department as to the coverage of visiting medical officers under that section. In relation to section 28 (6) I advise that the words in that section mirror the wording of section 28 (4), which has been in the Health Care Complaints Act since 2004. I thank the Opposition for its support for the bill. I commend the bill to the House.
Question—That this bill be now agreed to in principle—put and resolved in the affirmative.
Motion agreed to.
Bill agreed to in principle.
Passing of the Bill
Bill declared passed and transmitted to the Legislative Council with a message seeking its concurrence in the bill.